Reconstruction Period Research Articles

Vascularized Bone Graft in Mangled Hand Reconstruction

Extensive bone defects especially in conjunction with associated coverage involvement in mangled hands, pose significant challenges to hand and upper extremity surgeons. Vascularized bone grafts often play a vital role for effective treatment now-a-days. It not only bypasses the drawbacks of conventional grafts but also allows for simultaneous one stage reconstruction of its coverage as well as repairs other injured structures.Preoperative evaluation of mangled hand is crucial, the injury extent, including circulation, patient expectations and clinical reality should be all taken into consideration before finalizing the reconstruction plan. The fibula bone and other vascularized bone flaps such as iliac crest bone and medial femoral condyle and some others as well as corresponding spare part can provide effective solutions. Especially important considerations about surgeons’ experience and expertise , donor site morbidity , postoperative care and rehabilitation are essential for optimal outcomes. In this article , we would like to share our current practicing vascularized bone flaps in mangled hand reconstructions.

Advancing Precision Rhinoplasty: Preoperative Digital 3D Surgical Planning.

The aim of the study is to assess the efficacy and advantages of utilizing state-of-the-art three-dimensional (3D) reconstruction technology in preoperative planning for rhinoplasty surgery. It is a study of a single rhinoplasty case that was operated at a tertiary hospital. The patient was assessed through a detailed history, blood investigations, radiological investigations and preoperative 3D (three-dimensional) reconstruction of the face and nose. The study utilized high-resolution CT scans and 3D reconstruction software like 3D (three-dimensional) Slicer and Blender 3D (three-dimensional) to analyze nasal anatomy for preoperative planning in rhinoplasty. External and internal nasal measurements were taken, and axial cross-section analysis was conducted to assess nasal structure deviation. The benefits of 3D (three-dimensional) visualization in surgical planning were evaluated, and surgical management was based on preoperative reconstructions. Comprehensive preoperative evaluations were performed, adhering to ethical guidelines.Preoperative 3D (three-dimensional) reconstruction planning methods facilitated precise surgical planning and execution in rhinoplasty with satisfactory outcomes for both the patient and the surgeon. Incorporating 3D (three-dimensional) reconstruction technology in rhinoplasty preoperative planning enhances surgical precision and patient satisfaction, ensuring optimized surgical outcomes while adhering to ethical standards.

Oral Reconstruction with Locoregional Flaps after Cancer Ablation: A Systematic Review of the Literature.

Introduction: The planning of oral reconstruction after tumor resection is a pivotal point for head and neck surgeons. It is mandatory to consider two aspects: the size of the surgical defect and the complexity of the oral cavity as an anatomical region. We offer a review of the literature that focuses on four types of locoregional flaps that can be profitably used for such reconstruction: infrahyoid (IF), nasolabial (NF), platysma (PF), and submental (SF). Methods: The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. This systematic review was carried out according to the PICOS acronym through a comprehensive electronic search on PubMed/MEDLINE, Cochrane Library, and Google Scholar databases. For each selected article, we extrapolated eight main parameters, of which all mean values were compared through an ANOVA test. The dimensions of the oral defects were referred to as "small" (<7 cm2), "medium" (7-50 cm2), or "large" (>50 cm2). Results: A total of 139 articles were selected with a total of 5898 patients. The mean ages for each type of flap were not statistically significant (p = 0.30, p > 0.05). Seven sublocations of oral defects were reported: The most common was the tongue (2003 [34.0%] patients), followed by the floor of the mouth (1786 [30.4%]), buccal mucosa (981 [16.6%]), cheek (422 [7.2%]), hard palate (302 [5.1%]), alveolar ridge (217 [3.7%]), and retromolar trigone (187 [3.2%]). The defects were mainly medium-sized (4507 [76.4%] patients), and fewer were small-sized (1056 [17.9%]) or large-sized (335 [5.7%]). Complications were noted, the most frequent of which was flap necrosis, seen in 0.57% of cases. The functional and esthetical results were mainly positive. Conclusions: Locoregional flaps represent a good alternative in medium-sized defects as well as a fairly good alternative in small- and large-sized defects when other options are ruled out.

Closing the Loop on Revision: The Impact of Emotional Well-being on Elective Revision After Breast Reconstruction.

A diagnosis of breast cancer has a significant impact on a patient's physical and emotional health. Breast reconstruction improves quality of life and self-esteem following mastectomy. However, many patients undergo additional elective revision procedures after reconstruction. The aim of this study was to assess the relationship between perioperative emotional well-being and elective revisions in breast reconstruction. A retrospective review was performed of patients who underwent breast reconstruction with a single surgeon between January 2007 and December 2017. Revision procedures were defined as additional operations that fall outside the index reconstructive plan. Medical records were reviewed for a history of generalized anxiety disorder (GAD) and/or major depressive disorder. Multivariate analysis was performed to identify factors associated with revision. A total of 775 patients undergoing breast reconstruction were included, of whom 121 (15.6%) underwent elective revision. Overall, a history of any psychiatric history (P < .001), depression alone (P = .001%), and GAD and depression together (P = .003) were significantly associated with revision surgery. On multivariate logistic regression controlling for comorbidities and reconstruction modality, depression alone, and GAD and depression together were significantly associated with an increased likelihood of revision surgery (odds ratio, 3.20, P < .001; odds ratio, 2.63, P < .001). Perioperative emotional well-being and reconstruction modality impact the rate of secondary revision surgery. An understanding of the surgical and patient-related risk factors for revision can provide more informed patient-decision making and improve surgical planning.

Resident Evaluation of Reconstruction Challenges and Lessons Learned from the Great East Japan Earthquake: Recommendations for Reconstruction and Industrial Policies 12 Years after the Disaster

The year 2023 marks the 12th anniversary of the Great East Japan Earthquake (GEJE). Immediately after the disaster, the number of evacuees reached approximately 470,000, but by November 2022, the number had decreased to approximately 31,000. The reconstruction of housing, disposal of debris, public infrastructure development, and overall restoration and reconstruction has progressed steadily. However, a re-examination of the status of industrial restoration and reconstruction reveals that restoration and reconstruction have not progressed in some areas. This research statistically analyzes how the Japanese public perceives the issues around the recovery process and what memories and records they would like to learn from regarding the GEJE. The purpose of this study is to ask about reconstruction issues and lessons learned from the GEJE by conducting a web-based survey with 2000 respondents in Japan. The method of estimation is the use of ordinal logistic regression analysis to statistically estimate whether there are differences in recovery issues and lessons learned depending on individual attributes. The results suggest that those who are interested in, remember, and express anxiety about the recovery issues and lessons learned tend to be men, do not have children, are highly educated, and have a higher income. In sum, many of Japan’s citizens are highly interested in the reconstruction of agriculture, forestry, fisheries, housing, urban development, living environment, industry, and livelihood in the affected areas. In the future, they will play a central role in modernizing, scaling up, and integrating the agriculture, forestry, and fisheries industries, as well as in rebuilding towns and livelihoods. In the affected areas, it will be necessary to draw on the lessons learned from the GEJE and create reconstruction plans for the future, and then, policymakers will need to formulate reconstruction policies that reflect the concerns of the Japanese people.

Organised Spinozism in the Netherlands (1897–2022): Growth, Flourishing, Decay and Revival

This paper gives an outline of the history of organised Spinozism in the Netherlands, divided into three periods. In 1897 the Vereniging het Spinozahuis (VHS) was established. On the one hand, it wanted to preserve the physical and spiritual heritage of Spinoza, being an essential part of Dutch identity, and on the other hand, it strived for the propagation of Spinozism, which might fill the void left by the end of Christianity. This double aim precluded the transformation of the VHS into an international society to disseminate Spinozism. To that end the Societas Spinozana was established in 1920. It had to contribute to the solution of the spiritual crisis created by the WWI which had divided humanity. By the time of National-Socialism and during the post-war reconstruction period, in which philosophies incompatible with Spinozism dominated, the VHS successfully returned to the initial aim of preserving Spinoza’s heritage, but in the 1970s Spinozism once more became a viable alternative to traditional religion.

Three-dimensional fault model and features of chained hazards of the Luding MS 6.8 earthquake, Sichuan Province, China

The MS 6.8 Luding earthquake in 2022 is located on the NNW-trending Moxi segment of the Xianshuihe fault with left-lateral strike-slip behavior. This area is where the Xianshuihe, Anninghe, Daliangshan and Longmenshan faults intersect. China Earthquake Administration has identified that intersection area, among the Moxi segment of the Xianshuihe fault, the Anninghe fault, the Daliangshan fault and the southern part of the Longmenshan fault, as a high-magnitude earthquake hazard area. According to existing data on the Luding earthquake, including the focal parameters, the spatial distribution of re-located aftershocks, dominated azimuth of the earthquake intensities and earthquake-induced ground fissures, we built a 3D earthquake fault model. We found that two discontinuous NNW-trending vertical strike-slip faults with left stepping were the seismogenic faults of the Luding earthquake. Its coseismic left-lateral dislocation triggered transtensional slips and aftershocks on the NW-trending secondary faults at its northernmost tensile area. Meanwhile, local crustal coseismic shortening on the side of Mt. Gongga triggered the aftershocks on the NE- and NW-trending secondary conjugated strike-slip faults, which were confirmed by GNSS observations and InSAR deformation field around the epicenter. This earthquake rupturing pattern also controlled the spatial distribution of the earthquake intensity IX area and earthquake chain hazards. The Coulomb stress calculation shows that the Luding earthquake increases the risk of high-magnitude earthquake occurrence on the southernmost part of the Xianshuihe fault and the Anninghe fault. Finally, we suggested doing good monitoring of the Anninghe fault and the southernmost part of the Xianshuihe fault and avoiding active faults with seismogenic capacity and areas prone to earthquake-chained hazards during the site selection and planning of reconstruction.

Preoperative planning of craniectomy and reconstruction using three-dimension-printed cranioplasty for treatment of calvarial lesion.

Common calvarial lesions include fibrous dysplasia (FD), intraosseous meningioma, osteoma, Langerhans cell histiocytosis (LCH), intraosseous hemangioma, dermoid and epidermoid cyst, and malignancy. Surgical removal with removal of the involved skull is the choice of treatment for these lesions. Previously, the skull defect was repaired using allograft, and alloplastic materials have been replaced with newer polyetheretherketone (PEEK) material, which is more resistant, biocompatible, and can be 3-dimension (3D)--printed. High-resolution 3D printing uses very fine extruders to put materials in fine layers to recreate patients' anatomy authentically, which gives superior cosmetic outcomes. Our objectives were preoperative planning of craniectomy and reconstruction for calvarial lesions and reconstruction of skull defects using 3D-printed cranioplasty with PEEK materials. In this series, we describe 11 cases in which skull lesions were removed and reconstructed in the same sitting using a 3D-printed PEEK implant designed preoperatively using high-resolution computer tomography. All the cases were done in the neurosurgery department of Bangabandhu Sheikh Mujib Medical University from 2021 to 2023. Patients were followed up for 6 months after surgery. Regarding 11 cases, six cases were FD, three cases were intraosseous meningioma, one case was intraosseous hemangioma, and one case was LCH. Average lesion size were 12.73-5.77 cm. Cranioplasty was done with PEEK material. Minor complications were treated conservatively. Seroma, postoperative fever, and nausea were among these. The human bone-like biocompatibility and resistance to physical forces leads to more frequent use of PEEK, which enables to repair of complex craniofacial defects with better cosmesis. Despite some limitations, the PEEK cranioplasty implant continued to thrive and showed its promise to be an excellent material. Further, research and investment should be put into developing the technique.

Indocyanine Green Fluorescence-Guided Laparoscopic Anatomical Segmentectomy of Liver Segment 6: Surgical Strategy and Technical Details.

Because of the complex anatomy of the right posterior hepatic pedicle, there have been few reports on standardized laparoscopic portal territory staining-guided anatomical resection of liver segment 6 (LPTAR-S6). This study aimed to elucidate the indocyanine green (ICG) fluorescence staining methods for LPTAR-S6. LPTAR-S6 can be performed using positive and negative fluorescence staining approaches. We implemented these two approaches for patients with hepatocellular carcinoma. Descriptions of the surgical strategy and technical details are presented. Two patients safely underwent LPTAR-S6 using a preoperative three-dimensional reconstruction plan. The intraoperative ICG fluorescence staining effect was satisfactory, and the anatomical landmarks were fully exposed. A detailed preoperative three-dimensional reconstruction plan, complete intraoperative application of real-time laparoscopic ultrasound guidance, and ICG fluorescence staining can result in accurate transection of the liver parenchyma during LPTAR-S6.

In vivo bioluminescence tomography-guided system for pancreatic cancer radiotherapy research.

Recent development of radiotherapy (RT) has heightened the use of radiation in managing pancreatic cancer. Thus, there is a need to investigate pancreatic cancer in a pre-clinical setting to advance our understanding of the role of RT. Widely-used cone-beam CT (CBCT) imaging cannot provide sufficient soft tissue contrast to guide irradiation. The pancreas is also prone to motion. Large collimation is unavoidably used for irradiation, costing normal tissue toxicity. We innovated a bioluminescence tomography (BLT)-guided system to address these needs. We established an orthotopic pancreatic ductal adenocarcinoma (PDAC) mouse model to access BLT. Mice underwent multi-projection and multi-spectral bioluminescence imaging (BLI), followed by CBCT imaging in an animal irradiator for BLT reconstruction and radiation planning. With optimized absorption coefficients, BLT localized PDAC at 1.25 ± 0.19 mm accuracy. To account for BLT localization uncertainties, we expanded the BLT-reconstructed volume with margin to form planning target volume(PTVBLT) for radiation planning, covering 98.7 ± 2.2% of PDAC. The BLT-guided conformal plan can cover 100% of tumors with limited normal tissue involvement across both inter-animal and inter-fraction cases, superior to the 2D BLI-guided conventional plan. BLT offers unique opportunities to localize PDAC for conformal irradiation, minimize normal tissue involvement, and support reproducibility in RT studies.

Designing deaf spaces: education, hygiene, and citizenship in nineteenth-century France

ABSTRACT This article examines the changing architectural environments of deaf education in the nineteenth century, taking the national institutes in Paris and Bordeaux as its main focus. Founded in the late eighteenth century and initially housed in government-expropriated properties, both schools underwent comprehensive renovation and reconstruction projects in the nineteenth century to emerge as modern educational spaces. Although these projects remain overlooked in the history of modern architecture, they were closely tied to contemporary discourses on education, hygiene, and citizenship. The renovation of the Paris Institute for Deaf-Mutes during the 1820s–30s engaged pressing questions about hygiene and social progress in the postrevolutionary era of national reconstruction. The architectural transformation of the Bordeaux Institute for Deaf-Mute Girls from the 1860s not only reflected the changing pedagogical focus from sign language to oralism; it was also imbricated in broader debates about laïcité and educational standardisation as France transitioned from empire to republic. Far from being marginal, these institutions functioned as key sites for working through notions of citizenship and national identity. Their histories reveal how architectural and material frameworks could serve to impose ideology on the one hand, and provide important grounds for the formation of a minority community on the other.

Long-Term Follow-Up of Computer-Assisted Microvascular Mandibular Reconstruction: A Retrospective Study.

Background: Virtual surgical planning has become a well-established practice in head and neck surgery. In oncological surgery, it permits the achievement of safe margins resections and ensures functional reconstructions and optimal esthetic outcomes. This study aimed to evaluate the long-term outcomes after virtually planned mandibular microvascular reconstruction, focusing on functional and esthetic results, as well as health-related quality of life. Methods: A long-term retrospective evaluation of 17 patients with oral cavity malignancy who underwent computer-assisted mandibular resection and reconstruction was performed. Functional and esthetic outcomes were analyzed using the EORTC, QLQ-C30, H&N35, and FACE-Q questionnaires. Results: Time since reconstruction ranged from 7 to 14 years. Patients reported high functional levels on the QLQ-C30 functional scales but lower scores on H&N35. On FACE-Q, patients demonstrated higher appraisal and satisfaction with their smiles compared to their overall facial appearance. Conclusions: In this retrospective case series, patients undergoing computer-assisted mandibular reconstruction for oral malignancies achieved good long-term functional and esthetic outcomes. Although limited by the small sample size, these results support the enduring benefits of virtual planning for mandibular reconstruction. To minimize declines in function and appearance, considerations should include immediate dental implants, enhanced reconstruction of the temporomandibular joint, newer methods of radiotherapy to minimize xerostomia, and oral exercises to prevent trismus.

Serial Transverse Enteroplasty (STEP) versus Longitudinal Intestinal Lengthening and Tailoring (LILT): Systematic Review and Meta-Analysis of Outcomes and Complications

Abstract Background The prevalence of SBS is 3-4 per million. It occurs in about 15% of adult patients who undergo intestinal resection, with 3/4th of these cases resulting from massive intestinal resection and 1/4th from multiple sequential resections. About 70% of patients in whom SBS develops are discharged from the hospital and a similar percentage remain alive a year later. This improved survival rate has been achieved primarily by the ability to deliver long-term nutritional support. Objective To compare between Serial Transverse Enteroplasty (STEP) and Longitudinal Intestinal Lengthening and Tailoring (LILT) in the incidence of complications and clinical prognosis regarding morbidity and mortality in patients with Short Bowel Syndrome (SBS). Patients and Methods The search was carried out using the electronic national library of medicine PubMed database, Cochrane library and manual reference of articles published on serial transverse enteroplasty (STEP) versus longitudinal intestinal lengthening and tailoring (LILT) in management of patients with SBS. Conclusive search was done and duplicate studies were excluded. Data Sources Medline databases (PubMed, Medscape, ScienceDirect. EMF-Portal) and all materials available on the Internet till 2022. Results LILT and STEP are both valuable treatment strategies used in the management of pediatric SBS. However, currently, it is not possible to advise surgeons on accurate patient selection and to predict the result of either intervention. There is very limited published data on bowel lengthening procedure exclusively in adults. Most reported series exclusively or predominantly discuss the pediatric population with some adults included in one series and two additional single case reports. Conclusion Both STEP and LILT are potentially safe and effective methods for the treatment of SBS, under the conditions that the surgical techniques required have been mastered and the indications for surgery are observed. This review should be a gateway to open the scope on the field of Autologous Intestinal Reconstruction Surgeries (AIRS) and plan for a more detailed prospective studies with close monitoring of the data regarding outcomes, complications and follow up.

Reassembling Marseille’s mosaic: urban planning in service of a post-World War II imagined identity

ABSTRACT Socio-spatial divisions between districts in the North and South have marked the port-city of Marseille since the post-World War II urban reconstruction period. This article analyses the decades spanning the 1940s to the 1960s Vieux Port area as well as the HLM (Habitation à Loyer Modéré, or rent controlled properties) building projects in the North of the city. This reveals a dual strategy deployed by urban planners as well as municipal and national government officials in response to an increasing immigrant workforce involving relocation into HLMs and (re-)designing public spaces. City planners, architects, and officials aimed to reconfigure the neighbourhoods in which people were to be housed and to strengthen the narrative of Marseille as a Mediterranean gateway, attracting investors and tourists, a process which also helped the city to gain a favourable reputation in Europe. The way in which urban planning, social housing initiatives, and public space designs unfolded in post-World War II Marseille has played a pivotal role in shaping the city’s present-day social and geographical divisions.

Performance Assessment of Existing Asphalt Pavement in China’s Highway Reconstruction and Expansion Project Based on Coupling Weighting Method and Cloud Model Theory

In China, a substantial portion of highway asphalt pavements are no longer capable of accommodating increasing traffic volumes and necessitate renovation and expansion. Prior to commencing such activities, it is crucial to evaluate the performance of the existing asphalt pavements. This study developed a novel normal cloud framework integrating a comprehensive weighted indicator system for existing asphalt pavement. Five key performance indicators including riding quality index (RQI), rutting area ratio (Rr), cracking area ratio (Cr), patching area ratio (Pr), and pavement structural strength index (PSSI) were selected to holistically represent the pavement condition in highway renovation and expansion projects. Subsequently, a method was proposed to determine the weights of these indicators by integrating the analytic hierarchy process (AHP) and entropy. A normal cloud model was constructed to address data characteristics and representation of indicator fuzziness/randomness through digital cloud modeling. The model was applied to 12 sections of the Jingjintang Expressway (Tianjin section). The results revealed only one section where the normal cloud model differed from the pavement maintenance quality assessment (PQI) model. The 3D ground-penetrating radar detection results of this different section indicated that the normal cloud model more closely aligned with the road structure condition. Compared to absolute pass/fail criteria of the traditional PQI model, the cloud model offered enhanced sensitivity to define graded condition assessments essential for reconstruction planning and decision analysis. Therefore, the normal cloud model is more suitable for assessing the performance of existing asphalt pavements in highway reconstruction and extension projects compared to the PQI model.

Evaluation of forest loss data using fractal algorithms: case study Eastern Carpathians–Romania

Logging causes the fragmentation of areas with direct implications for hydrological processes, landslides, or habitats. The assessment of this fragmentation process plays an important role in the planning of future logging, reconstruction, and protection measures for the whole ecosystem. The methodology used includes imaging techniques applying two fractal indices: the Fractal Fragmentation Index (FFI) and the Fractal Fragmentation and Disorder Index (FFDI). The results showed the annual evolution and disposition of deforested areas. Only 3% of deforestation resulted in the fragmentation and splitting of forest plots. The remaining 97% resulted in the reduction of existing compact stands without fragmentation. The method has many advantages in quantifying the spatial evolution of forests, estimating the capture of carbon emissions and establishing sustainability of bird and animal habitats. The analysis took place in the Eastern Carpathians, in Romania, in the time period of 2001–2022.

Long-term outcomes in virtual surgical planning for mandibular reconstruction: A cost-effectiveness analysis.

This study is an economic evaluation comparing virtual surgical planning (VSP) utilization to free hand mandibular reconstruction (FHR) for advanced oral cavity cancer, for which the cost effectiveness remains poorly understood. The proposed clinical benefits of VSP must be weighed against the additional upfront costs. A Markov decision analysis model was created for VSP and FHR based on literature review and institutional data over a 35-year time horizon. Model parameters were derived and averaged from systematic review and institutional experience. VSP cost and surgical time saving was incorporated. We accounted for long-term risks including cancer recurrence and hardware failure/exposure. We calculated cost in US dollars and effectiveness in quality-adjusted-life-years (QALYs). A health care perspective was adopted, discounting costs and effectiveness at 3%/year. Deterministic and probabilistic sensitivity analyses tested model robustness. In the base case scenario, total VSP strategy cost was $49,498 with 8.37 QALYs gained while FHR cost was $42,478 with 8.27 QALY gained. An incremental cost-effectiveness ratio (ICER), or the difference in cost/difference in effectiveness, for VSP was calculated at $68,382/QALY gained. VSP strategy favorability was sensitive to variations of patient age at diagnosis and institutional VSP cost with one-way sensitivity analysis. VSP was less economically favorable for patients >75.5 years of age or for institutional VSP costs >$10,745. In a probabilistic sensitivity analysis, 55% of iterations demonstrated an ICER value below a $100,000/QALY threshold. VSP is economically favorable compared to FHR in patients requiring mandibular reconstruction for advanced oral cancer, but these results are sensitive to the patient's age at diagnosis and the institutional VSP cost. Our results do not suggest if one "should or should not" use VSP, rather, emphasizes the need for patient selection regarding which patients would most benefit from VSP when evaluating quality of life and long-term complications. Further studies are necessary to demonstrate improved long-term risk for hardware failure/exposure in VSP compared to FHR.

Reflection of changes in post-war architecture and town planning of Kharkiv in periodical specialist publications

The article provides a historiographical overview of publications about the architecture and construction of Kharkov in professional architectural journals of Ukraine during the period of post-war reconstruction (1947-1955) and during the transition period of “changes in the artistic direction of Soviet architecture.” The article contains a description of the views and positions of Kharkov architects on current architectural and urban planning issues. This period of development of Kharkiv architecture and urban planning is fundamentally conceptually and stylistically heterogeneous. Accordingly, around the middle of the 1950s, the nature of the content and tone of the publications changed significantly. This is due to ideological and political transformations in the country as a whole, and in particular radical changes in the "ideological and creative direction" of Soviet architecture. The topics of the publications of Kharkiv architects considered in this article cover a wide range from the main provisions of the General Plans of the city to a critical examination of the features of specific buildings, as well as the problems of professional training of architects. The authors of the researched publications are architects-designers, construction engineers, officials, including the main architects of the city at that time, teachers of architectural universities. The beginning of the researched period is the post-war reconstruction of Kharkiv, the publications of the first post-war decade reflect the current architectural and urban planning practice, the prospects for the implementation of various aspects of the first master plan for the development of the city. Literary sources of the mid-1950s fully reflect the turn in the direction of the development of architecture on the example of Kharkov. Professional magazines pay more attention not to architectural activity, but to construction problems. The change in the name of the magazine indirectly indicates the beginning of a change in attitude towards the profession of an architect. The final part of this article will be published later; it covers publications during the transition to industrial construction of the 1960s - early 1970s.

REGARDING THE ISSUE OF INSTITUTIONAL ENSURING THE SUSTAINABLE DEVELOPMENT OF RURAL AREAS

The need to improve institutional approaches to the socio-economic development of rural areas is outlined, primarily from the side of the effectiveness of state administration in promoting the sustainable development of rural areas. Emphasis is placed on the need to form effective institutional support that will meet modern challenges in overcoming the problems of rural development, regulate the socio-economic and ecological aspects of development in the period of post-war reconstruction of Ukraine. It was found that in order to increase the effectiveness of the implementation of strategic tasks and regulatory and programmatic documents in achieving the goals of sustainable development of rural areas, they should be determined by rural administrations and rural communities.

New finger reconstruction technologies using 3D printing

Introduction The use of 3D printing technology in finger reconstruction improves accuracy of the procedure minimizing the donor defect and optimizing the appearance and function of the finger. The use of this technology in the finger reconstruction with an osteocutaneous radial forearm flap with axial blood supply and lengthening of the digital stumps and metacarpals remains poorly explored.The objective of the study was to demonstrate new methods of preoperative planning for finger reconstruction and improve surgical outcomes.Material and methods Outcomes of five patients treated with original methods based on 3D technology were retrospectively evaluated during preoperative planning, reconstruction of the thumb using an osteocutaneous radial forearm flap with axial blood supply, relocation of the stump of the third finger and lengthening of the stumps of the first and second metacarpals. The patients could achieve consolidation of interpositional bone allografts following lengthening of the finger stumps, stability of the bone base of the finger, organotypic restructuring of the marginal allograft during plastic surgery with an osteocutaneous radial forearm flap, and a functional position of the reconstructed thumb using the middle finger stump.Results and discussion An individual device for planning finger reconstruction allows identification of the optimal size and position of the finger in three planes, which is essential for patients with severe hand deformities to avoid corrective procedures. An individual guide was used to osteotomize the radius to harvest a vascularized graft providing a cutout of a given size and shape and a cortical-cancellous allograft being identical in shape and size to replace the donor bone defect. The combined use of Masquelet technology and distraction of the finger stump or a metacarpal improved conditions for consolidation and restructuring of the interpositional allograft preventing fractures and infection.Conclusion The use of 3D technology in finger reconstruction using an osteocutaneous radial forearm flap with axial blood supply and distraction of the finger stumps and metacarpals can improve surgical outcomes.